Discontinuation of Antihypertensive Drug Use Compared to Continuation in COVID-19 Patients: A Systematic Review with Meta-analysis and Trial Sequential Analysis.

INTRODUCTION: COVID-19 related mortality is about 2%, and it increases with comorbidities, like hypertension. Regarding management, there is debatable evidence about the benefits of continuation vs. discontinuation of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers (ACEI/ARB). AIM: We performed a systematic review to assess the effects and safety of in-hospital discontinuation compared to continuation of ACEI/ARB in COVID-19 patients. METHODS: We systematically searched on PubMed, Scopus, and EMBASE from inception to June 19, 2021. We included observational studies and trials that compared the effects and safety of continuing ACEI/ARB compared to discontinuing it in COVID-19 patients. Effects sizes for dichotomous variables were expressed as risk ratios (RR) and 95% confidence intervals. For continuous variables, effects were expressed as mean difference (MD). We used random effect models with the inverse variance method. We assessed certainty of evidence using the GRADE approach. RESULTS: We included three open-label randomized controlled trials and five cohort studies. We found that the continuation group had lower risk of death compared with the discontinuation group only in the cohort group (RR: 0.46, 95% CI: 0.24-0.90), but not in the RCT group (RR: 1.22, 95% CI: 0.75-2.00). The ICU admission rate was significantly lower in the continuation group (RR: 0.46, 95% CI: 0.31-0.68) in the cohort group, but not in RCT group (RR: 1.03, 95% CI: 0.67-1.59). We did not find significant differences between groups regarding hospitalization length, hypotension, AKI needing renal replacement therapy, mechanical ventilation, new or worsening heart failure, myocarditis, renal replacement therapy, arrhythmias, thromboembolic events and SOFA AUC. The GRADE approach revealed that the certainty ranged from moderate to high level. CONCLUSIONS: There is no significant difference in mortality and other outcomes between continuation and discontinuation groups.

Factors associated with mortality in patients hospitalized for COVID-19 admitted to a tertiary hospital in Lambayeque, Peru, during the first wave of the pandemic.

INTRODUCTION: COVID-19 caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spread worldwide, becoming a long-term pandemic. OBJECTIVES: To analyze the factors associated with mortality in patients hospitalized for COVID-19 in a tertiary hospital in the Lambayeque region of Peru. METHODS: A retrospective cohort study of patients with a diagnosis of COVID-19, hospitalized in a hospital in northern Peru, was conducted from March to September 2020. RESULTS: Of the 297 patients studied, 69% were women, the mean age was 63.99 years (SD = ±15.33 years). Hypertension was the most frequent comorbidity (36.67%), followed by diabetes mellitus (24.67%) and obesity (8.33%). The probability of survival at 3 days of ICU stay was 65.3%, at 7 days 24.2%, and 0% on day 14. Risk factors associated with mortality in patients hospitalized for COVID-19 are age, male sex, tachypnea, low systolic blood pressure, low peripheral oxygen saturation, impaired renal function, elevated IL-6 and elevated D-dimer. CONCLUSIONS: Mortality in hospitalized patients with COVID-19 was 51.18 per 100 persons, Mortality was found to be associated with hypertension, type of infiltrating, and sepsis.

Retinal vascular occlusion in patients with the Covid-19 virus.

BACKGROUND: The coronavirus disease (COVID-19) can cause acute respiratory distress syndrome with dyspnea, anosmia, fever, and cough. Few studies describing ocular findings have been reported. The current case series, reports the clinical findings and natural history of patients with retinal vascular occlusion after COVID-19 infection. CASE PRESENTATIONS: Patients from multiple Brazilian hospitals who had clinical and laboratory diagnoses of COVID-19 with retinal vein or arterial occlusion were analyzed retrospectively. The baseline demographics, clinical presentations of COVID-19, comorbidities, risk factors for thromboembolic events, and use of anticoagulant drugs were reviewed. The relevant clinical findings associated with the retinal vascular occlusive event, management, and outcomes were reported. Fourteen cases of retinal vascular occlusion within 3 months of the laboratory confirmed COVID-19 infection were identified. Three of which required hospitalization for COVID-19 management. Eight cases had central retinal vein occlusion, three branch retinal vein occlusion, one hemispheric retinal vein occlusion, and two central arterial occlusion. The mean patient age at presentation was 48 years; the visual acuity ranged from light perception to 20/20. Nine patients received intravitreal injections of anti-angiogenic drugs and one received ketorolac tromethamine drops for the management of secondary macular edema; four were untreated. CONCLUSIONS: COVID-19 patients may rarely have ocular manifestations of the disease. It was presented a case series of vascular occlusion events that may be related to COVID-19 infection, since these thrombotic events are actively involved in the disease pathophysiology. These cases emphasize the need for further investigation of ocular complications associated with this disease.

Hyperactive immature state and differential CXCR2 expression of neutrophils in severe COVID-19.

Neutrophils are vital in defence against pathogens, but excessive neutrophil activity can lead to tissue damage and promote acute respiratory distress syndrome. COVID-19 is associated with systemic expansion of immature neutrophils, but the functional consequences of this shift to immaturity are not understood. We used flow cytometry to investigate activity and phenotypic diversity of circulating neutrophils in acute and convalescent COVID-19 patients. First, we demonstrate hyperactivation of immature CD10- subpopulations in severe disease, with elevated markers of secondary granule release. Partially activated immature neutrophils were detectable 12 wk post-hospitalisation, indicating long term myeloid dysregulation in convalescent COVID-19 patients. Second, we demonstrate that neutrophils from moderately ill patients down-regulate the chemokine receptor CXCR2, whereas neutrophils from severely ill individuals fail to do so, suggesting an altered ability for organ trafficking and a potential mechanism for induction of disease tolerance. CD10- and CXCR2hi neutrophil subpopulations were enriched in severe disease and may represent prognostic biomarkers for the identification of individuals at high risk of progressing to severe COVID-19.

Optimal quarantine, isolation, and social distancing strategies for COVID-19 based on a mathematical model

Around 221 countries in the world are currently suffering from the COVID-19 pandemic and the World Health Organization reported there are 217.7 million confirmed cases with 4.5 million deaths tolls as of 31st August 2021. Until a cure is found, it is more appropriate to follow the health guidelines recommended by authorities. Theoretically, forecasting the courses and possible outcomes of such a pandemic is crucial for healthcare sectors to make decisions in advance. This paper aims to find optimal quarantine, isolation, and social distancing strategies for COVID-19 based on the SEIQJR mathematical model with a proper cost analysis. Minimising the cost of the controlling process of diseases is very important for public health policymakers. An optimal control problem is considered with a proposed cost functional which is minimised to yield optimal control strategies. We subsequently insert an inequality state constraint to the problem by considering the possible maximum capacities of hospitals. Copyright © 2022 Inderscience Enterprises Ltd.

COVID-19 Changes Public Awareness about Food Sustainability and Dietary Patterns: A Google Trends Analysis.

The COVID-19 pandemic has not only affected healthcare systems and global economies but also directly impacted food security and purchasing behaviors. The aim of this study is to investigate if COVID-19 has induced changes in public interest regarding Food Sustainability and healthy-sustainable dietary patterns across Europe and in European regions. A Google Trends search was performed using the search terms "Food Sustainability + Sustainable Diet + Sustainable Food" (grouped as "Food Sustainability") and the topics "Sustainability", "Healthy Diet", "Mediterranean Diet", and "Flexitarianism" for the years 2010 to 2022. Data were obtained for 12 countries in Europe. The trends in interest after the COVID-19 outbreak were forecast based on previous data. After the COVID-19 outbreak, an increase in Food Sustainability interest was observed and was higher than forecast based on the previous data. A significant interest increase in Sustainability was observed; nevertheless, this increase was smaller than the forecast increase. Mixed results were obtained for dietary patterns across European regions, yet, considering the mean interest for Europe, it seems that the COVID-19 pandemic outbreak dampened the interest in dietary patterns such as the Healthy Diet and Flexitarianism and promoted an interest in the Mediterranean Diet. Understanding consumers' beliefs and behaviors toward food choices is crucial for the transition towards sustainable diets, and definitions of educational and behavioral interventions are essential to this transition.

Higher Adherence to the Mediterranean Dietary Pattern Is Inversely Associated With Severity of COVID-19 and Related Symptoms: A Cross-Sectional Study.

Background and Aims: Adherence to the Mediterranean diet (MD) has been associated with a decreased risk of developing a variety of chronic diseases that are comorbidities in COVID-19 patients. However, its association to the severity and symptoms of COVID-19 are still unknown. This study aimed to examine the association between adherence to the MD pattern and COVID-19 severity and symptoms in Iranian hospitalized patients. Methods: In this cross-sectional study, 250 COVID-19 patients aged 18 to 65 were examined. We employed a food frequency questionnaire (FFQ) to obtain data on dietary intake of participants in the year prior to their COVID-19 diagnosis. COVID-19 severity was determined using the National Institutes of Health's Coronavirus Disease 2019 report. Additionally, symptoms associated with COVID-19, inflammatory markers, and other variables were evaluated. The scoring method proposed by Trichopoulou et al. was used to assess adherence to the MD. Results: The participants' mean age was 44.1 ± 12.1 years, and 46% of them had severe COVID-19. Patients who adhered more closely to the MD had lower serum C-reactive protein levels (7.80 vs. 37.36 mg/l) and erythrocyte sedimentation rate (14.08 vs. 42.65 mm/h). Those with the highest MD score were 77% less likely to have severe COVID-19 after controlling for confounding variables. The MD score was also found to be inversely associated with COVID-19 symptoms, including dyspnea, cough, fever, chills, weakness, myalgia, nausea and vomiting, and sore throat. Conclusion: Higher adherence to the MD was associated with a decreased likelihood of COVID-19 severity and symptoms, as well as a shorter duration of hospitalization and convalescence, and inflammatory biomarkers.

The epitranscriptome of Vero cells infected with SARS-CoV-2 assessed by direct RNA sequencing reveals m6A pattern changes and DRACH motif biases in viral and cellular RNAs.

The epitranscriptomics of the SARS-CoV-2 infected cell reveals its response to viral replication. Among various types of RNA nucleotide modifications, the m6A is the most common and is involved in several crucial processes of RNA intracellular location, maturation, half-life and translatability. This epitranscriptome contains a mixture of viral RNAs and cellular transcripts. In a previous study we presented the analysis of the SARS-CoV-2 RNA m6A methylation based on direct RNA sequencing and characterized DRACH motif mutations in different viral lineages. Here we present the analysis of the m6A transcript methylation of Vero cells (derived from African Green Monkeys) and Calu-3 cells (human) upon infection by SARS-CoV-2 using direct RNA sequencing data. Analysis of these data by nonparametric statistics and two computational methods (m6anet and EpiNano) show that m6A levels are higher in RNAs of infected cells. Functional enrichment analysis reveals increased m6A methylation of transcripts involved in translation, peptide and amine metabolism. This analysis allowed the identification of differentially methylated transcripts and m6A unique sites in the infected cell transcripts. Results here presented indicate that the cell response to viral infection not only changes the levels of mRNAs, as previously shown, but also its epitranscriptional pattern. Also, transcriptome-wide analysis shows strong nucleotide biases in DRACH motifs of cellular transcripts, both in Vero and Calu-3 cells, which use the signature GGACU whereas in viral RNAs the signature is GAACU. We hypothesize that the differences of DRACH motif biases, might force the convergent evolution of the viral genome resulting in better adaptation to target sequence preferences of writer, reader and eraser enzymes. To our knowledge, this is the first report on m6A epitranscriptome of the SARS-CoV-2 infected Vero cells by direct RNA sequencing, which is the sensu stricto RNA-seq.

Higher Adherence to the Mediterranean Dietary Pattern Is Inversely Associated With Severity of COVID-19 and Related Symptoms: A Cross-Sectional Study

Background and Aims Adherence to the Mediterranean diet (MD) has been associated with a decreased risk of developing a variety of chronic diseases that are comorbidities in COVID-19 patients. However, its association to the severity and symptoms of COVID-19 are still unknown. This study aimed to examine the association between adherence to the MD pattern and COVID-19 severity and symptoms in Iranian hospitalized patients. Methods In this cross-sectional study, 250 COVID-19 patients aged 18 to 65 were examined. We employed a food frequency questionnaire (FFQ) to obtain data on dietary intake of participants in the year prior to their COVID-19 diagnosis. COVID-19 severity was determined using the National Institutes of Health's Coronavirus Disease 2019 report. Additionally, symptoms associated with COVID-19, inflammatory markers, and other variables were evaluated. The scoring method proposed by Trichopoulou et al. was used to assess adherence to the MD. Results The participants' mean age was 44.1 ± 12.1 years, and 46% of them had severe COVID-19. Patients who adhered more closely to the MD had lower serum C-reactive protein levels (7.80 vs. 37.36 mg/l) and erythrocyte sedimentation rate (14.08 vs. 42.65 mm/h). Those with the highest MD score were 77% less likely to have severe COVID-19 after controlling for confounding variables. The MD score was also found to be inversely associated with COVID-19 symptoms, including dyspnea, cough, fever, chills, weakness, myalgia, nausea and vomiting, and sore throat. Conclusion Higher adherence to the MD was associated with a decreased likelihood of COVID-19 severity and symptoms, as well as a shorter duration of hospitalization and convalescence, and inflammatory biomarkers.

STRONG HUMORAL IMMUNE RESPONSE TO SARS-COV-2 VACCINE ADDITIONAL DOSE AMONG PATIENTS WITH INFLAMMATORY BOWEL DISEASES

Background: Current recommendations in many countries support additional COVID-19 vaccine doses in patients with inflammatory bowel disease (IBD) who are treated with immunosuppressants, yet real-world data on the effectiveness and safety of additional vaccine doses is lacking. We sought to quantify the humoral immune response to an additional (third) dose of mRNA vaccines in adolescents and adult patients with IBD. Methods: We performed a direct-to-patient, internet-based cohort study of patients with IBD in the United States who have received any SARS-CoV-2 vaccine granted EUA. Participants completed baseline and follow-up surveys and had blood work obtained approximately 8 weeks following completion of the initial vaccination series and 6 weeks following administration of an additional (third) vaccine dose. We performed quantitative measurement of antireceptor binding domain (RBD) IgG antibodies specific to SARS-CoV-2 using the LabCorp Cov2Quant IgG™ assay. Results: A total of 659 participants were included [415 participants (63%) initially received BNT162b2, 243 participants (37%) initially received mRNA-1273, and 5 participants (1%) initially received Ad26.COV2.S]. Demographic, clinical, and treatment characteristics of the study population are provided in Table 1. Over 98% of those receiving an initial mRNA vaccine received the same type additional dose. Whereas 93% had detectable antibody after the initial vaccination series, 99.5% had detectable antibodies following an additional dose. Mean (SD) increase in antibody level was 61 ug/mL (103) in those receiving BNT162b2 and 78 ug/mL (143) for those receiving mRNA-1273 (Figure 1). Importantly, of 47 of patients without initial antibody response, 45 (96%) had detectable antibodies following an additional dose. Additional vaccination was generally well tolerated in this population, with 44%, 24%, 25%, and 6% reporting no, mild, moderate, and severe side effects respectively. Discussion: These findings demonstrate robust immunogenicity to additional doses of SARS-CoV-2 vaccine, even amongst patients with undetectable antibody following the initial series. Adverse event rates were low. These data can be used to inform vaccine decisions in patients with a broad array of immune-medicated conditions frequently managed by immunosuppression. (Table Presented) (Figure Presented)

Training Trainers in the Management of Older Persons with Dementia during the COVID-19 Pandemic (preprint)

During the COVID-19 pandemic, education activities for the prevention and management of chronic health conditions needed to adapt to meet their learning objectives. Dementia is a chronic disease that is one of the contemporary epidemics in Latin America and the Caribbean (LAC). Objective: To describe and analyse the impact of the design and results of "The Management of the Elderly with Dementia” Course of the Latin American Academy of Medicine of the Elderly (ALMA) remotely taught to teachers and specialists in geriatrics from various countries of Latin America and the Caribbean (LAC). Methodology: A course focused on learning and competencies was designed, including two phases of synchronous and asynchronous activities. An evaluation strategy was designed to assess the level of learning and the teaching strategy itself.Results: Of the 120 university geriatrics professors who applied, 60 participants were selected, one of whom declined to participate before starting the course. On the course initiation, 89 participants from 20 countries included teachers (6 speakers, 12 advisors, and 12 tutors) and students (59). The participants were professors from 49 universities in LAC and 3 in Europe. A total of 57 (98.25%) students achieved a satisfactory grade, and 17 (29.8%) obtained an excellent grade. Only one student failed. No student dropped out from the course. Self-perception of learning was greater than 70%. The opinions regarding the evaluation of the design, teaching methodology, content quality, quality of teachers, and virtual learning environment were mainly "good and very good". Conclusions: The virtual course model implemented was successful and efficient and can be used for teaching the topic analysed or adjusted to another issue.

Modeling and Simulation of Online Examinations Procedures in COVID-19 Pandemic Using Arena Software: A Case Study

The outbreak of Coronavirus disease 2019 (COVID-19) has made higher education institutions around the world shift to online education. Online exams are exponentially expanding as part of this online education. Although online exams have been implemented a few decades back, there are still impacts on online evaluation methods, gaps in students' priorities, and challenges with academic dishonesty. In this study, Arena simulation is used for determining the feasibility of the framework proposed for online exams during the COVID-19 pandemic. The study investigates the implementation of online exams from three different perspectives that include students, academic staff and administrates at a state university in Sri Lanka that moved into online education and online exams amidst the COVID-19 pandemic. The framework is derived from the data collected through the mixed research method. By following a scenario-based study, the performance of the framework is simulated with Arena that determines its feasibility for real-world applications. Overall findings of this study suggest best approaches to conduct students' evaluations in online education as an alternative to coping with challenges where threats to continue academic performance. © 2022 IEEE.

Detecting COVID-19 Pneumonia using Chest X-rays through Deep Learning Techniques

The COVID-19 pandemic has caused devastating effects on global health, the economy, and people's daily lives, and timely diagnosis is crucial to control the spread. The need for additional testing methods has increased due to the limitations in current testing methods. This study focused on applying deep learning methods to classify chest X-rays as COVID-19 pneumonia, normal, and non-COVID pneumonia. We developed two deep learning models to ascertain COVID-19 using Posteroanterior (PA) and Anteroposterior (AP) view Chest X-rays. Two datasets of 300 chest X-rays for PA and AP views were used. As the first deep learning model, a new Convolutional Neural Network from scratch was built. Then, VGG16, VGG19, and ResNet50 transfer learning models were used. Finally, the transfer learning models were extended by adding more layers to the top of the existing model. As the first part of this study, we used PA view X-rays and obtained 98% overall accuracy, and 98% precision, 99% recall, and 99% f1-score for the COVID-19 class. In the second part, we used AP view X-rays and obtained 79% overall accuracy, and 96% precision, 83% recall, and 89% f1-score for the COVID-19 class. Finally, gradient-based class activation maps were generated using the proposed extended VGG19 model to visualize the areas that helped the model in detecting COVID-19. This research showed that high performance could be obtained in detecting COVID-19 using extended transfer learning models. In PA view X-rays, the proposed extended VGG-19 model performed the best, and in AP view X-rays, the proposed extended ResNet50 model performed the best. © 2022 IEEE.

End-to-End Automated Crossword Solver using Image Processing, Natural Language Processing and Neural Network

Solving newspaper crosswords improves human brain function and mental health. It also helps decrease depression and anxiety that occurs due to social isolation and loneliness in the COVID-19 pandemic. In this game, players are enthusiastic about finding the correct answer after solving the puzzle. However, to check the answers, players have to wait until the newspaper publishes the solution. Due to this delay, players are moving to online crosswords. Mainly this issue occurs in Sri Lanka. There is no quick way to verify the answers using existing methods because players need the technical knowledge to use the solver. Also, existing solvers are unable to provide accurate solutions for different clue types. This paper provided an automated crossword puzzle solver which can solve British-Style crosswords using an image of the crossword puzzle. Image Processing, Natural Language Processing, and Neural Networking technologies were used to implement the proposed solution. The final answer list was prepared using the neural network model and filled the puzzle grid using OpenCV. The proposed system achieved more than 90% of word and letter accuracy in evaluation with human experts. © 2022 IEEE.

Profile of overweight and obese patients attending the medical nutrition clinic at - Teaching Hospital Anuradhapura. Sri-Lanka

Background: Obesity is a chronic inflammatory condition that increases the risk of multiple non-communicable diseases. Thus, impairing the quality of life. The prevalence of overweight and obesity among Sri-Lankan adults were 25.5 and 9.2 in 2010 with a rising trend adding a huge burden on the health sector. Overweight and obesity is rising even among the rural farming communities in Sri-Lanka, reflecting the double burden of malnutrition. The escalating trend can be attributed to easy accessibility leading to increased consumption of energy-dense food and increased sedentary behaviour which has replaced the traditional farming methods. The burden was further increased due to multiple effects of COVID 19 lockdown. Medical nutrition therapy with the 'plate model' is an effective method of weight reduction by portion size control of staple food and by increasing non-starchy vegetables and protein intake. The objective of the study was to assess the outcomes of the 'plate model' as a dietary intervention among patients with overweight and obesity. Methods: A retrospective descriptive study was conducted using secondary data of 281 overweight and obese patients who attended the medical nutrition clinic from January - June 2021. Inclusion criteria captured all patients above 19 years of age who attended the clinic at least once. All patients were counselled regarding the plate model by medical officers who have post-graduate qualifications in clinical nutrition. Descriptive statistics were used to analyse the data. Results: Out of the total observed patients, 77% were females and 23% were males. The median age was 45 years with 31.7% between 40 - 49 years and 7.8% above the age of 60 years. Distribution within each BMI category was similar among both genders, with 45% of both females and males belonging to obesity class 1. More than 80% of patients' occupation was related to agriculture. Defaulted follow up was 69% while 31% had subsequent clinic visits. Among the followed-up patients (n=88) the majority (46.8%) have lost less than 0.5kg per week, while 37.5 % lost more than 0.5kg per week. Among the patients who lost weight less than 0.5kg per week (n= 42), 52% belonged to overweight category and 50% to morbidly obese category. It was also revealed that 53% of patients who lost weight more than 0.5kg per week were in the obesity class 1 category. Conclusion: The study suggests the 'plate model' along with regular and close monitoring is an effective method of weight reduction. Results also indicate the need for increasing awareness on the importance of clinic follow up. Further research is needed to evaluate the reasons for a higher number of defaulters.

Neutrophils in severe COVID-19 are characterized by a hyperactive immature state and maintained CXCR2 expression (preprint)

Neutrophils are vital in defence against pathogens but excessive neutrophil activity can lead to tissue damage and promote acute respiratory distress syndrome (ARDS). COVID-19 is associated with systemic expansion of immature neutrophils but the functional consequences of this shift to immaturity are not understood. We used flow cytometry to investigate activity and phenotypic diversity of circulating neutrophils in COVID-19. First, we demonstrate hyperactivation of immature CD10- subpopulations in severe disease, with elevated degranulation of secondary granule markers. Partially activated immature neutrophils are detectable three months post symptom onset, indication long term myeloid dysregulation in convalescent COVID-19 patients. Second, we demonstrate that neutrophils from moderately ill patients downregulate the chemokine receptor CXCR2, while neutrophils from severely ill individuals failed to do so, suggesting altered ability for organ trafficking. CD10- and CXCR2hi neutrophil subpopulations were enriched in severe disease and may represent biomarkers for early identification of individuals at high risk of progressing to severe COVID-19.

The traditional Mediterranean diet is effective in the prevention and treatment of acute and recurrent inflammatory diseases of childhood.

In the recent SARS-CoV-2 pandemic, disease severity was found to be more related to the immune system hyper-response than the invasive or destructive capacity of the virus. Similarly, most common childhood diseases, which are generally recurrent and inflammatory, may be caused by a hyper-response or inability of the immune system. Individuals will react differently to causal noxa and outcomes will depend on the balance and maturity of their immune system. Conventionally, childhood diseases are symptomatically treated with little attention being devoted to balancing and stimulating the maturation of the immune system. Recently, there has been an increase in publications that consider lifestyle as an important factor in the maintenance of health. One controversial angle is an abandonment of the traditional diet and the inclusion of foods that are potentially less well-assimilated by the human species. An increasing number of studies are demonstrating the anti-inflammatory effects of the Mediterranean Diet while illustrating the pro-inflammatory effects of many other food types. We believe that the Traditional Mediterranean Diet consists of foods that support the establishment and maintenance of a healthy microbiota and a mature immune system that, in turn, can aid in the prevention of common inflammatory and recurrent diseases of childhood.

Effects of vaccination against COVID-19 on the emotional health of Peruvian older adults (preprint)

BackgroundCOVID-19 vaccination may reduce anxiety and depression. However, the pandemic significantly impacted the elderly from low-middle-income countries. Therefore, we aimed to estimate the effect of vaccination against COVID-19 on the emotional health of older adults. MethodsWe selected a nationally stratified sample of non-hospitalized adults aged 60 to 79 years who intended to receive the COVID-19 vaccine or had already received it during recruitment. We assess the fear, anxiety, and worry about COVID-19, general anxiety, and depression at baseline and after a month. We estimated the adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for each altered emotional health outcomes in those who had one and two doses, compared with those who were not vaccinated using multilevel logistic regression with mixed effects. ResultsWe recruited 861 older adults. Loss to follow-up was 20.8%. At baseline, 43.9% had only one dose of the vaccine, and 49.1% had two doses. In the analysis during follow-up, those who had two doses had less fear (ORa: 0.19; CI95%: 0.07 to 0.51) and anxiety to COVID-19 (ORa: 0.45; CI95%: 0.22 to 0.89), compared to non-vaccinated. We observed no effects in those with only one dose. LimitationsInability to obtain the planned sample size for primary analysis. There is a selection bias during recruitment and a measurement bias because of self-reported vaccination. ConclusionsCOVID-19 vaccination with two doses in elders improves the perception of COVID-19 infection consequences. This information could be integrated into the vaccination campaign as its beneficial effect. HighlightsO_LIUp to 90% of elders in a Peruvian sample had at least one dose of COVID-19 vaccine C_LIO_LITwo doses of COVID-19 vaccine reduced the levels of fear and anxiety for COVID-19 C_LIO_LIOnly one dose of vaccine didnt had effect in any emotional mental outcome C_LI

Scalable Adaptive PDE Solvers in Arbitrary Domains

Efficiently and accurately simulating partial differential equations (PDEs) in and around arbitrarily defined geometries, especially with high levels of adaptivity, has significant implications for different application domains. A key bottleneck in the above process is the fast construction of a good adaptively-refined mesh. In this work, we present an efficient novel octree-based adaptive discretization approach capable of carving out arbitrarily shaped void regions from the parent domain: An essential requirement for fluid simulations around complex objects. Carving out objects produces an incomplete octree. We develop efficient top-down and bottom-up traversal methods to perform finite element computations on incomplete octrees.We validate the framework by (a) showing appropriate convergence analysis and (b) computing the drag coefficient for flow past a sphere for a wide range of Reynolds numbers (O(1106)) encompassing the drag crisis regime. Finally, we deploy the framework on a realistic geometry on a current project to evaluate COVID-19 transmission risk in classrooms. © 2021 IEEE Computer Society. All rights reserved.